Provider Demographics
NPI:1134467939
Name:GRIFFITH, HOLLY LYNN (ATC)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:LYNN
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:600 GRESHAM DR
Mailing Address - Street 2:STE 204
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1904
Mailing Address - Country:US
Mailing Address - Phone:757-388-5680
Mailing Address - Fax:757-388-5681
Practice Address - Street 1:600 GRESHAM DR STE 204
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1904
Practice Address - Country:US
Practice Address - Phone:757-388-5680
Practice Address - Fax:757-388-5681
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-29
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110005477363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant